目的 积累临床病例，观察167例精细个体化131I治疗中老年Graves甲亢疗效。方法 回顾性分析167例中老年Graves甲亢应用131I治疗，引入个体化治疗方案矫正系数，根据甲状腺大小、质地、年龄、病程、抗甲状腺药物(ATD)治疗、并发症、手术、有效半衰期等指标对矫正系数进行精细化调整服131I剂量，跟踪随访一年。结果 精细个体化131I治疗用于167例中老年Graves甲亢，服131I后3个月、6个月、12个月患者临床症状显著改善，血FT3、FT4、TSH较治疗前明显降低（P<0.05），甲亢完全缓解率80.24%，部分缓解率7.78%，总有效率98.8%，其中甲状腺功能低下（甲低）者15例，占9.0%。131I治疗后12个月，Graves眼病、甲亢性心脏病的缓解率分别为83.72%和82.14%。结论 精细个体化131I治疗中老年Graves甲亢疗效显著，副作用小，具有很好的应用价值，在临床治疗中值得推广。

Objective To evaluate the 131I treatment effect in middle and older-aged patients with Graves’ hyperthyroidism. Methods Retrospective analysis was carried out to evaluate that fine and individual 131I treatment effects on the senile Graves hyperthyroidism in 167 cases of middle and older-aged patients. Based on the thyroid size, texture, age, course, antithyroid drugs (ATD) treatment, complication, operation and effective half-life of patients, the individual treatment correction coefficient was introduced to correctly adjust the dose of 131I. The one-year follow-up after treatment was followed. The recurrence of symptoms, side-effects, improvement of thyroid function were used to evaluate the curable effects. Results The clinical symptoms in 167 cases of senile Graves hyperthyroidism patients were significantly improved with fine individual 131I treatment after 3, 6 and 12 months. The serum levels of FT3, FT4 and TSH in patients after treatment were significantly lower than that of pre-treatment (P < 0.05). The complete recovery rate of hyperthyroidism was 80.24% and partial recovery rate of that was 7.78% with total effective rate 98.8%, including 15 cases of thyroid hypofunction (9.0%). Graves ophthalmopathy and hyperthyroidism heart disease were decreased to the rate of 83.72% and 82.14%, respectively. Conclusion Fine individual 131I treatment for middle and older-aged patients with Graves’ hyperthyroidism has good curative effect, and is worth popularization in clinical treatment.